Effects of different doses of esketamine on hemodynamic indexes, pain stress indexes, and VAS scores in patients with benign ovarian tumors undergoing laparoscopic resection induced by remifentanil

This study aimed to investigate the effects of different doses of esketamine on hemodynamic indicators, pain stress indicators and Visual Analog Scale (VAS) scores in patients undergoing laparoscopic resection for benign ovarian tumors induced by remifentanil. A total of 110 patients with benign ovarian tumors scheduled for laparoscopic resection between June and December 2023 were included in the study and divided into three groups: Group A (35 cases), Group B (37 cases), and Group C (38 cases), based on their anesthesia regimen. Anesthesia induction for all groups included propofol, remifentanil, and cisatracurium. Group A received an intravenous dose of 0.8 mg/kg esketamine, Group B received 0.6 mg/kg esketamine and Group C did not receive esketamine. The results revealed statistically significant differences in average arterial pressure and heart rate at various time points within each group (p < 0.05), and significant differences were observed in Substance P (SP) and Prostaglandin E2 (PEG2) at three different time points within each group (p < 0.05). VAS scores during and after surgery at 6 and 12 hours significantly differed among the three groups (p < 0.05). There was a significant difference in awakening time among the three groups (p < 0.05). However, there were no statistically significant differences in the incidence of adverse reactions among the three groups (p > 0.05). In conclusion, both 0.6 mg/kg and 0.8 mg/kg doses of esketamine effectively prevented remifentanil-induced hyperalgesia in patients undergoing laparoscopic resection for benign ovarian tumors, significantly reducing patient pain. Notably, the 0.6 mg/kg dose of esketamine demonstrated better hemodynamic stability, promoted patient recovery, and showed superior clinical utility compared to the 0.8 mg/kg dose.